Provider Demographics
NPI:1730075060
Name:HEFNER, VIRGINIA (AUD)
Entity type:Individual
Prefix:
First Name:VIRGINIA
Middle Name:
Last Name:HEFNER
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1126 REUTLINGER AVE APT 410
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40204-1976
Mailing Address - Country:US
Mailing Address - Phone:540-266-0122
Mailing Address - Fax:
Practice Address - Street 1:731 SPECKMAN RD
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40243-1876
Practice Address - Country:US
Practice Address - Phone:502-215-3860
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-13
Last Update Date:2025-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY299910231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist